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Vestibular schwannoma: role of conservative management

Suryanarayanan, R; Ramsden, RT; Saeed, SR; Aggarwal, R; King, AT; Rutherford, SA; Evans, DG; (2010) Vestibular schwannoma: role of conservative management. Journal of Laryngology and Otology , 124 (3) 251 - 257. 10.1017/S0022215109992362. Green open access

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Abstract

Objective: To assess the outcome of conservative management of vestibular schwannoma.Study design: Observational study. Setting: Tertiary referral centre.Patients: Four hundred and thirty-six patients with vestibular schwannoma (490 tumours), including 327 sporadic tumours and 163 tumours in 109 patients with neurofibromatosis type two.Main outcome measures: The relationship of tumour growth to tumour size at presentation, and to certain demographic features.Results: The initial tumour size was significantly larger in the neurofibromatosis type two group (11 mm) than in the sporadic vestibular schwannoma group (5.1 mm). In both groups, 68 per cent of tumours did not grow during follow up (mean 3.6 years; range one to 14 years). The mean growth rate was 1.1 mm/year (range 0-15 mm/year) for sporadic tumours and 1.7 mm/year (range 0-18 mm/year) for neurofibromatosis type two tumours. The tumour growth rate correlated positively with tumour size in the sporadic tumour group, and correlated negatively with age in the neurofibromatosis type two group.Conclusion: Two-thirds of vestibular schwannomas did not grow. Radiological surveillance is an acceptable approach in carefully selected patients. Once a sporadic vestibular schwannoma reaches 2 cm in intracranial diameter, it is likely to continue growing. We do not recommend conservative management for sporadic tumours with an intracranial diameter of 1.5 cm or more. Vestibular schwannoma management is more complex in patients with neurofibromatosis type two.

Type: Article
Title: Vestibular schwannoma: role of conservative management
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S0022215109992362
Publisher version: http://dx.doi.org/10.1017/S0022215109992362
Language: English
Additional information: Copyright Cambridge University Press 2009
Keywords: Neuroma, Acoustic, Magnetic Resonance Imaging, Neurofibromatosis 2, Follow-up studies, Acoustic neuromas, Growth-rate, Natural-history, Tumor-growth, Neurofibromatosis-2, Neurinomas, Rates
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > The Ear Institute
URI: https://discovery.ucl.ac.uk/id/eprint/1320842
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